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Social factors better indicators of premature mortality than skin color or geography

It's no real news that the color of your skin and the location of your home can affect how long you may live - past work has established that. But there is now evidence that we should look beyond these things when thinking about mortality: In a new study, Stanford researchers identified 22 socioeconomic and environmental variables that together are better indicators of early death than are race or geography.

As I describe today in a releaseMark Cullen, MD, and colleagues used national data sources to examine probability of survival to age 70 for each sex-race group by county. They first identified wide variation in premature mortality from county to county and between blacks and white (as expected), and then:

The researchers... examined the effect of 22 socioeconomic and environmental variables on the survival-to-age-70 figures in each race/sex group. They found that factors such as education, income, job and marital status account for most of the differences between the various groups.

Cullen explained, “Once certain factors — such as the fraction of adults in the county who finish high school, the fraction with managerial or professional jobs and the fraction of adults who live in two-parent households — are accounted for, even geography, such as being in the South, is moot.”

It’s not where the county is located that is important. “It’s the socioeconomic variables that turn out to be so predictive,” Cullen said. “In a region where education status is incredibly low, jobs and family structure are terrible, and there is no wealth, people’s health is not going to be good.”

The team tested their work by running what Cullen described to me as a "thought experiment," during which they analyzed what would happen if the 22 variables were equal among black and whites. The result? “Amazingly, almost all of the projected mortality differences evaporate,” Cullen told me. “In this hypothetical experiment, the chances of survival until 70 would be almost identical for whites and blacks.”

So what does this all mean? Cullen summed up the work, which appears online in PLoS ONE, by saying “Geographic and racial disparities are best understood as related to disparities in education, occupations and the like." And this could certainly be instructive for policymakers as they consider (and try to prevent) premature mortality.

Previously: Report reveals disparities in well-being among racial and ethnic groups in U.S.
Photo by Ed Yourdon

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